To link to the entire object, paste this link in email, IM or documentTo embed the entire object, paste this HTML in websiteTo link to this page, paste this link in email, IM or documentTo embed this page, paste this HTML in website

U N C L I N E B E R G E R C O M P R E H E N S I V E C A N C E R C E N T E R • S P R I N G 1 9 9 7 CANCER L I N E S
U N C S C H O O L O F M E D I C I N E • U N C H O S P I T A L S
Pagano Receives State’s Highest Honor
Joseph S. Pagano, director
of the UNC Lineberger Compre-hensive
Cancer Center and
Lineberger Professor of Cancer
Research, was honored last
December with the 1996 North
Carolina Award for Science. It is
the highest civilian honor the
state can bestow. North Carolina
is one of only a handful of states
to have a citizen awards program.
“ Dr. Pagano has earned
international recognition for
his ground- breaking research
and I’m proud he has received
the North Carolina Award,”
said Governor James B. Hunt,
Jr. “ His dedication has helped
cancer patients and AIDS
patients live longer, and our state is
very lucky to have him.”
Pagano’s research has focused on
the Epstein- Barr virus ( EBV), a human
herpesvirus that causes mononucleosis
and has been linked to several types of
cancer. He was recognized for his land-mark
development of new ways to de-tect
viruses in cells by looking for viral
DNA. Through his research, Pagano
discovered that the DNA of EBV was
present in both an African cancer
called Burkitt’s lymphoma and in naso-pharyngeal
carcinoma, a cancer com-mon
in southern China. This discov-ery
showed that EBV could cause can-cer
in two very different types of cells.
I N S I D E T H I S I S S U E . . .
Message from the Director . . . . . . . . . . 2
Clinical Trials Underway . . . . . . . . . . . . . 3
In Profile: Bill Cance . . . . . . . . . . . . . . . 5
UNCDiscovers Tumor Defense . . . . . . 6
Cancer Study & Diet Research. . . . . . . 7
Genetic Counseling . . . . . . . . . . . . . . . . 8
Soybeans KeyTo Cancer Control . . . 10
Support Groups . . . . . . . . . . . . . . . . . 11
He then found that EBV remained
in the host cell as a minichromosome
in these cancers. This viral fragment,
an episome, partners with the host
cell’s DNA and is replicated when the
cell divides, allowing EBV to persist
indefinitely in the body after infection.
Other herpesviruses may use similar
strategems.
“ Discovering how viruses
replicate and persist is part of
Dr. Pagano’s long- term goal
of learning how to control viral
infection,” Gov. Hunt said in
his citation.
Pagano also received acco-lades
from his colleagues. “ Dr.
Pagano is one of the few in-dividuals
in this country whose
contributions range from basic
virology at the molecular and
cellular levels through in vitro
studies of antiviral activity
to the conduct of clinical trials
with effective antiviral drugs,”
notes Dr. Gertrude B. Elion,
a Nobel Laureate scientist at
Glaxo Wellcome cancer center
member emeritus. Pagano’s
research with HIV and antiviral drugs
laid the groundwork for the creation of
the AIDS Center at UNC. It also
prompted the FDA to seek his advice
on the first HIV vaccine based on gene
transfer. Elion credits him with develop-ing
one of the strongest cancer center
programs in the nation with training,
research and outreach components.
Continued on page 3
Dr. Joseph Pagano, Center director, receives the North Carolina Award
from Governor James B. Hunt
by Margot Carmichael Lester
SPRING 1997 VOLUME 7, ISSUE I
PAGE 2
Director’s Message
CANCER L I N E S
Coming to completion is our
new building. This summer, four
structures will merge, linking physi-cally
for the first time the center’s
research programs in basic, clinical
and public health sciences. The
glass- enclosed, domed atrium will be
the space through which everyone
passes, a place of encounter that
captures the interdisciplinary culture
of the center. It will be a place of
discovery and light. We anticipate a
fall dedication ceremony.
Also coming to completion is my
time as director. I am excited about
what will come next: a new director
who will infuse new ideas and leader-ship
while keeping the best of the
past. There is more to be accom-plished
as Director Emeritus, and I
will continue as Lineberger Professor
of Cancer Research, with more time
for my laboratory program — now
come full circle from basic studies of
viral genes to the treatment of human
cancer grown in mice. I will continue
to direct the center’s postdoctoral
training program, now ranked nation-ally
with those at the top. Attracting
the best and the brightest young
people to cancer research is one of the
more rewarding of our priorities.
Twenty- three years ago when
most cancer centers were working on
proving therapies that were already
available, I knew that we would need
to go back to a more fundamental
approach. It would be rooted in
understanding how cancer arises in
the cell, a conviction coming from
working with viruses in cells. Folded
Dr. Joseph S. Pagano
in this first plan would be cancer
control research through UNC’s
excellent School of Public Health.
Rapid payoffs would come from pre-vention
and early detection of cancer.
We were already treating cancer
patients, ever mindful of the pressing
need for the best therapy. Clinical
research would be developed as the
Center had something new to offer.
We have been steadfast in following
that plan. The emergence of cancer
genetics, unexpected as it was, fit well
with this strategy, but picked up the
tempo.
I know full well that patients
with cancer want action: not just new
facilities, new faculty, and new pro-grams
in clinical research, but a
beneficial fusion between discovery in
the laboratory and the best in treat-ment
and care, and a leap from
insight into cancer genes to forecast-ing
cancer susceptibility to guide
prevention.
The vision of the center has been
tested, and it is now affirmed by the
waves of discovery of how cancer
arises in the cell and the genes that
predict behavior of cancer and suscep-tibility
to those most insidious of
diseases. The cancer center has the
momentum to be in the vanguard to
the finish. n
Cancer Lines is a
semi- annual publication
of the UNC Lineberger
Comprehensive Cancer
Center, The University of
North Carolina School of
Medicine at Chapel Hill.
Dr. Joseph S. Pagano, Director
Dianne G. Shaw, Director of
Communications/ Executive Editor
Margot Carmichael Lester, Editor
n Please remove me from your mailing list
Name
n Please add the following to the Cancer
Center’s mailing list
Name
Address
City, State, Zip
UNC Lineberger
Comprehensive Cancer Center
CB# 7295
School of Medicine
University of North Carolina at Chapel Hill
Chapel Hill, NC 27599- 7295
( 919) 966- 3036
UNC Lineberger is designated a
comprehensive cancer center by the
National Cancer Institute.
VOLUME 7, ISSUE I SPRING 1997 CANCER L I N E S
PAGE 3
These are just a few highlights from
Pagano’s long career. “ The superlative
work of the UNC Lineberger
Comprehensive Cancer Center is the
ultimate measure and tribute to
Dr. Pagano’s leadership,” notes Stuart
Bondurant, M. D., interim dean of the
UNC School of Medicine.
“ While Dr. Pagano would be the
first to point out that many distin-guished
and able people have contrib-
PAGANO RECEIVES AWARD
Continued from page 1
NEWS BRIEFS
UNC Clinical Trials Underway
with a new drug, paclitaxel, which has
been shown to be very effective in
shrinking tumors of the esophagus,
head and neck area, breast, lung and
ovaries. Paclitaxel also appears to
be especially effective when used along
with irradiation in patients with
cancers of the lung or throat. The trial
is to show that this combination
of three drugs and irradiation is more
effective than the first two were with
irradiation and that it can be delivered
safely to patients with these tumors.
Recurrent Leukemia and
Lymphoma ( GW 1002) — This trial
will study the effectiveness and side
effects of a new drug called ARA- G,
which is being developed by Glaxo
Wellcome for treatment of patients
with recurrent leukemia and lym-phoma.
Initial work with this drug has
shown that it is very effective in treat-ing
certain patients with these
diseases. This study will examine the
drug’s ability to shrink these tumors
For more information on these and
other trials, please call the Clinical
Protocol Office at 919- 966- 4432.
Pancreatic Cancer ( LCCC 9620)
— This trial uses the first drug,
Gemcitabine, which has ever been
approved by the FDA for the treat-ment
of pancreatic cancer. Patients
with pancreatic cancers that cannot
be removed surgically will receive
Gemcitabine along with irradiation
to the tumor mass. It is believed
that along with Gemcitabine’s anti-tumor
activity, there is also reason
to expect that it will increase the
effectiveness of the irradiation and
make the tumor that much more
likely to shrink.
Esophageal Cancer ( LCCC 9622)
— This trial is for patients with
large, inoperable cancers of the
esophagus. Patients will receive a
combination of three chemotherapy
drugs, two of which have been used
at UNC to treat this cancer, along
when the medicine is given by a dif-ferent
schedule than it was in earlier
trials. The treatment includes receiv-ing
three days of the medicine in the
hospital. Treatments are repeated
every four weeks if there is evidence
of the cancer’s improving with
therapy.
Ovarian Cancer ( GOG- 164) —
This randomized trial will compare
two different treatments in patients
who had a good, but not complete,
response to standard doses of
chemotherapy as initial treatment for
their ovarian cancer. One group of
patients will receive six additional
cycles of standard doses of carbo-platin
and paclitaxel. The other
group will receive a single treatment
with high doses of chemotherapy and
blood stem cells ( stem cell trans-plant)
for any residual ovarian cancer
found at the time of the second- look
surgery. n
uted to building the Center,” Bon-durant
continues, “ it is also true that
the Center’s greatness rests upon his
vision, commitment, personal and sci-entific
standards, scientific competence
and personal sensitivity and warmth.”
“ Dr. Pagano’s career exemplifies
that work as a scientist can make a
difference to society,” says Mary K.
Estes, Ph. D., a former student who is
now professor of molecular virology at
the Baylor College of Medicine and
president of the American Society for
Virology. “ He always showed this by
exhibiting a can- do attitude. This
doesn’t mean that everything always
comes easily, but he has shown that
one must be persistent to fulfill one’s
dreams. This attitude translated into
real accomplishments for the people
of North Carolina.”
Concludes Bondurant: “ The ulti-mate
result of Dr. Pagano’s leadership
is tangible improvement in the preven-tion,
diagnosis and treatment of cancer
in North Carolina, throughout the
nation and the world.” n
SPRING 1997 VOLUME 7, ISSUE I
PAGE 4
CANCER L I N E S
counselors, works to increase aware-ness
about breast cancer and partners
with community health organizations
to offer breast cancer control activities.
Using the U. S. Championship grant,
SOS will create educational materials
and a videotape for the program.
SOS was begun in 1990 as a part
of the UNC Minority Cancer Control
Research of the UNC Lineberger
Comprehensive Cancer Center. n
— compiled by Melyssa Allen
breast cancer prevention and detec-tion,
awarded the Center a total of
$ 45,000. The funds will be used for
the Center’s SPORE and Save Our
Sisters ( SOS) programs.
The UNC Breast Cancer SPORE
( specialized Program of Research
Excellence) is one of six such programs
in the country funded by the National
Cancer Institute ( NCI). SPOREs
are national leaders in breast cancer
research with a focus on translating
new discoveries in scientific and
clinical practices. UNC Lineberger
will use the $ 25,000 grant to further a
frontiers program that will allow for
new, one- year research projects target-ing
breast cancer treatment, early
detection and education.
The SOS program received a
$ 20,000 grant. SOS works to improve
breast cancer education for older
African- American women living
in the Wilmington area. The program,
which offers social support and
counseling through 128 lay health
DEVELOPMENT NEWS
Organizations Fund Breast Cancer Research
Two organizations have lent
considerable financial support to the
UNC Lineberger Comprehensive
Cancer Center for its clinical programs
in breast cancer research.
BREAST CANCER RESEARCH
FOUNDATION GIFT
The Breast Cancer Research Foun-dation,
founded in 1993 by Evelyn
Lauder of the Estee Lauder Com-panies,
gave $ 85,000 to the Center for
its clinical programs in breast cancer
research. Awards were given to 10
grantees across the nation at the
Foundation’s luncheon at NewYork
City’s Metropolitan Club on October
28, 1996. Barbara Walters of ABC
News presented the award.
“ The Breast Cancer Research
Foundation takes great pride in our
association with the UNC Lineberger
Comprehensive Cancer Center,”
Lauder said. “ Let us hope that by
working together, we move closer to
answering the many questions about
breast cancer and to finally eradicating
this dread disease.”
U. S. WOMEN’S OPEN
CHAMPIONSHIP GIFT
Two new grants from the 1996
U. S. Women’s Open Championship
will allow the UNC Lineberger
Comprehensive Cancer Center to pro-vide
new ways to treat breast cancer,
increase early detection and improve
breast cancer education.
The Championship, held in 1996
in Southern Pines to raise money for
Evelyn Lauder,
founder of the
Breast Cancer
Research Foun-dation,
presents
a 1996- 1997
Clinical Breast
Cancer Research
award to Dr.
Edison Liu, asso-ciate
professor
of medicine, and
Denise Bittner,
director of devel-opment
of the
UNC Lineberger
Comprehensive
Cancer Center.
Susan G. Komen Foundation
June 7, 1997
Meredith College
Raleigh, NC
For more information, call
919- 493- CURE
Race For The Cure
OR or lab, Cance engages in another
kind of gene- based activity: he’s an
avid gardener who propagates hybrid
gladioluses, just like his father.
FROM THE OPERATING
ROOM TO THE LAB
Cance and his team have un-covered
a new gene, called FAK,
which is involved in cellular signaling.
It was first found in a human tumor
taken from a sarcoma in a UNC
patient. “ The FAK gene is important
because it turns on as tumor cells
invade or metastasize. When it turns
off, the tumor cells die off,” Cance
explains. Researchers are studying the
gene now to discover how to use
it in treating cancer and preventing
metastases.
Research is the key to finding
new therapies and preventive measures
for cancer, Cance notes. At UNC,
information is taken directly from the
operating room to the lab, providing
almost instant access to cancer cells
for detailed study. Cance is involved
in the entire process, operating on
patients and then studying the cancer
cells. “ The sample is examined for
genes abnormally expressed — then
we try to figure out what makes it a
bad actor or a good actor.”
“ The key is taking the information
we find in the lab back to the patient,”
he continues. “ That’s what we pride
ourselves on here.” n
IN PROFILE
Surgeon/ Researcher Links OR and Lab
Bill Cance is one of those people
who actually grew up to be exactly
what he told his fourth grade class he
wanted to be: a surgeon. Today, if you
ask the associate professor of surgery
what he likes most about his job, he’ll
respond without hesitation. “ I love
taking care of people with complex
cancers.” A surgical oncologist, he
likes nothing better than a challenging
case so he specializes in cancers of the
upper abdomen and pelvis and breast.
“ One- hundred years ago we had
nothing in terms of surgical oncology,”
Cance notes.“ Then we had extraordi-narily
radical surgical solutions, like
mastectomy or colostomy. Today we’ve
found we can achieve the same results
with much less radical surgery.”
That change is especially notice-able
in the surgical options for breast
and colorectal cancers, he says. For
instance, mastectomies can often
be replaced with lumpectomies and
radiation; colostomies can often be
replaced with local excision or other
procedures.“ That translates into less
fear on the patient’s part which might
lead people to seek treatment sooner
instead of avoiding a worst- case
scenario. Conquering patients’ fear of
treatment is critical.”
LOOKING BEYOND
Not content to look at cancer
solely from a surgical standpoint,
Cance shuttles between the operating
room and the lab, trading his surgical
greens for his lab coat and back again.
Cance’s research aims to do the same
thing.
“ I like to ask the next question,”
Cance says. “ I look beyond the surgical
solution to what can we do to impact
the disease.” That makes him a perfect
fit at UNC, where a truly collaborative
approach to cancer treatment and
prevention is practiced. “ At UNC, the
three cancer specialties work together
to form a multidisciplinary team.”
That means medical, surgical and radi-ological
oncologists work together in
treating each patient. That’s rare —
in many other institutions, specialists
work independently. “ Our collabora-tive
environment means better care for
our patients — and a stronger research
agenda.
“ Down the road, novel thera-peutics
for cancers are the key,” Cance
predicts. Gene- directed therapies are
particularly promising and have gotten
his attention. That’s not surprising —
when he’s not treating cancer in the
PAGE 5
VOLUME 7, ISSUE I SPRING 1997 CANCER L I N E S
protein activates expression of or “ turns
on,” genes involved in cell survival.
Two related papers by scientists
at the Salk Institute in La Jolla, Calif.,
and the Massachusetts Institute of
Technology also appear in Science.
The papers report findings — limited
to tumor necrosis factor — similar to
those of the UNC- CH investigators.
As a group, the three reports appear to
explain why clinical trials using tumor
necrosis factor to fight cancer have
been disappointing.
“ This is a good example of how
basic research on gene expression and
cell biology can have important impli-cations
for cancer and clinical treat-ment,”
Baldwin said. “ We didn’t start
out studying this as a potential cancer
therapy but rather to understand
its biology. Working at the Lineberger
Cancer Center helped us appreciate
how our work could translate into
a real payoff in cancer treatment.” n
grammed cell death that enables the
body to clear the way for new cells.
Wang, Mayo and Baldwin found that
a substance known as NF- kappa B
prevents apoptosis from occurring in
cancer cells even after they have been
subjected to radiation, chemotherapy
or another killing compound called
tumor necrosis factor. NF- kappa B is a
major transcription factor — a protein
that attaches to DNA inside the
nucleus of cells and turns genes on and
off like a switch.
“ This factor protects the cells from
the killing mechanisms induced by
cancer therapies,” Baldwin said. “ We
also found that by blocking activation
of NF- kappa B, we make these cancer
therapies much more effective in
killing tumor cells in tissue culture.”
It is not known yet how NF- kappa B
prevents cell death or why blocking it
causes tumor cells to die, Baldwin said.
He and his colleagues assume that the
Anaturally occurring mechanism
that allows tumors to protect them-selves
against radiation treatment and
chemotherapy has been discovered
by scientists at the University of
North Carolina at Chapel Hill School
of Medicine. The researchers also have
figured out how to turn that mecha-nism
off.
If their discovery works as well in
patients as it has on a variety of
cultured human cancer cells, it could
improve cancer treatment and boost
survival significantly, the scientists say.
A report on the findings appeared
in the journal Science. Authors are
Cun- Yu Wang, a UNC- CH curriculum
in genetics and molecular biology
graduate student, Dr. Marty W. Mayo,
postdoctoral fellow, and Dr. Albert
S. Baldwin Jr., associate professor
of biology, all at the UNC Lineberger
Comprehensive Cancer Center.
The National Institutes of Health sup-ported
the research.
“ We are very excited about this
work and our clinical people here are
excited, too,” Baldwin said. “ We are
optimistic that it will improve cancer
therapy, and it offers real hope for stub-born
tumors like lung cancer. “ Depend-ing
on the success of animal studies
now under way, preliminary human tri-als
could start within a year,” he said.
The research concentrated on
apoptosis — a natural process of pro-
SPRING 1997 VOLUME 7, ISSUE I
NEWS BRIEFS
UNC Scientists
Discover Tumor
Defense, How
To Switch It Off
PAGE 6
CANCER L I N E S
Lucy and John Bode of Raleigh, NC, received the 1996 Outstanding Service Award at the Lineberger
Center’s Board of Visitors meeting. The Bodes are founding members of the Board of Visitors, serving on
the Board since its creation in 1984, and on its executive committee. ( l- r) Center director Dr. Joseph
Pagano; Lucy Bode; John Bode; Center deputy director Dr. Shelley Earp.
LINEBERGER SNAP SHOT
NEWS BRIEFS
PAGE 7
VOLUME 7, ISSUE I SPRING 1997 CANCER L I N E S
New Colon
Cancer Study
Among Blacks
and Whites
Afour- year, $ 2.6 million grant
from the National Cancer Institute is
allowing researchers at the University
of North Carolina at Chapel Hill
Schools of Medicine and Public
Health to launch what they believe is
the largest study of colon cancer in
both black and white races.
Colon cancer has been the second-leading
cancer killer in America for
the past 25 years. Deaths have been
decreasing among whites but increas-ing
among blacks and no large studies
have ever been done to find out why.
“ We have a lot of questions we
hope to answer,” said Dr. Robert
Sandler, professor of medicine, UNC
Lineberger member and principal
investigator. “ When people move from
a low- incidence area such as Africa or
Japan to a high- incidence area such as
the United States, the disease rates go
up. That strongly suggests that some-thing
in the environment rather than
simply genetics is responsible.”
Thirty- three counties in central
and eastern North Carolina, 50 hos-pitals,
800 colon cancer patients and
800 healthy control subjects will be
involved.
“ For us to come up with valid,
useful answers we need as many eligi-ble
people as possible to participate.”
He plans on contacting patients
through the North Carolina Central
Cancer Registry by mail and then by
phone to seek their cooperation,
after getting permission from their
physicians.
“ One of the strengths of our study
will be that we will be able to look at
a comprehensive list of factors such as
diet and physical activity in such a
large group,” Sandler explains. This is
a great opportunity for people in the
community and the University to help
one another by learning why blacks
in this country are at a greater risk of
dying from colon cancer than whites.”
Cancer Center members Drs.
Robert Millikan and Beth Newman of
epidemiology, and Alice Ammerman
of nutrition, are involved in the study.
Also taking part are Drs. John Woosley
of pathology, Lawrence Kupper of
biostatistics and Richard Rippe of
medicine.
Diet Research
For Blacks
Could Help
Prevent Cancer
Astudy by the School of Public
Health at the University of North
Carolina at Chapel Hill is focusing on
reducing the risk of cancer among
black North Carolinians by helping
them change their eating habits.
The program, headed by nutrition
professor Dr. Boyd Switzer, is a church-based
effort in eight North Carolina
counties: Bladen, Craven, Cumber-land,
Durham, Harnett, New Hanover,
Onslow and Pender.
The $ 4 million study, funded by
the National Cancer Institute, is the
first of its kind to focus specifically on
black Americans and help them learn
about cancer preventive foods, said
Switzer, a member of the UNC Line-berger
Comprehensive Cancer Center.
“ The study’s goal is to encourage
people to change their diets,” Switzer
explains. “ That is very difficult. We are
looking at the barriers and motivators
that behavioral change, and we are
looking at ways to measure that dietary
change.” Switzer said encouraging
people to eat more fruits and vegeta-bles
is important because research
studies consistently link the two food
groups with preventing cancer.
Blacks are at greater risk of develop-ing
cancer and dying from the disease
than whites, Switzer said. In 1997,
the American Cancer Society esti-mates
that 560 of every 100,000 blacks
will develop cancer compared to 469
of every 100,000 whites.
The program will offer educational
services aimed at lifelong eating
changes that will include food events,
health fairs and pastoral assistance
through bulletins, sermons and coun-seling.
Also included will be small
group activities like kitchen workshops
and church member input. Congre-gations
will receive bulletins, a
self- help “ Food for Health” packet,
inspirational booklets and audio tapes.
Participants will go through a
dietary risk test and complete a food
frequency survey after each phase
of the study, expected to be between
18 months and two years. n
— compiled by Claire Datillo
because a series of genes must fail be-fore
susceptibility is apparent. “ The way
heredity works in cancer has only re-cently
been appreciated as technologies
were developed to isolate genes. Now
we can diagnose cancer and test for
cancer susceptibility genes, but we can’t
cure all cancers yet,” says Skrzynia.
VALUABLE INFORMATION
“ You don’t inherit cancer, you in-herit
susceptibility to develop cancer,”
Skrzynia says. For instance, genetic
counseling is useful in about 5- 10% of
breast cancer and colon cancer cases.
“ In general, when there are multiple
family members diagnosed with cancers
of any sort, counseling can help to sort
out sporadic cases.”
Information is key to finding cancer
early and managing it effectively
SEVERAL BRANCHES
Genetic counseling is a broad field,
but there are three main branches: pre-natal,
pediatric and adult- onset diseases.
Prenatal genetic counseling involves
looking at the genetic makeup of a fetus
and estimating outcomes. More people
are probably familiar with this kind of
genetic counseling, Skrzynia says.
“ Pediatric genetic counseling, broadly
speaking, is geared towards problems in
development,” she adds.
But adult onset disease presents a
new area of genetic counseling. The
key here is detecting the gene or genes
which do not work properly. In some
diseases, such as Huntington’s disease
or neurofibromatosis, scientists know
there is one gene which determines
whether an individual will develop the
disease. Cancer is more complicated
SPRING 1997
CLINICAL REPORT
Genetic Counseling and Cancer
VOLUME 7, ISSUE I
Jane ( not her real name) is a
35- year- old African American woman.
For the past two years, she and her
sister have been caring for their
mother, Betty. Betty was diagnosed 15
years ago with breast cancer. After
a mastectomy, Betty did very well, but
cancer recurred in the other breast.
Betty has two sisters diagnosed
with breast cancer — three out of six
sisters suffer from the disease. Her
mother, Jane’s grandmother, died from
complications of “ female cancer,”
possibly uterine or ovarian cancer.
Jane has realized that cancer, as
she put it, “ runs in the family.” She,
her sister and her many cousins worry
about getting cancer and about
their own daughters. Jane recently read
a magazine article about the “ cancer
gene” and genetic testing. Should she
be tested? What is it all about?
A group of medical professionals
at UNC Lineberger work with people
like Jane every day to help them and
their families understand heredity
and disease. They work with people
with breast cancer, colon cancer, and
other types of cancer.
“ Genetic counseling is a com-munication
process,” Cecile Skrzynia,
a genetic counselor says.“ We explain
to patients and families facts about
hereditary diseases and what the risks
are to family members. Then we
talk about options for management.
Basically, genetic counselors help
people make decisions and choose
options to fit their families.”
PAGE 8
CANCER L I N E S
Genetic counselor Cecile Skrzynia talks with a breast cancer patient about the patient’s family history.
VOLUME 7, ISSUE I SPRING 1997 CANCER L I N E S
PAGE 9
Scientists at Pennsylvania State
University and the University of
North Carolina at Chapel Hill
have discovered a gene dubbed
KISS- 1 that controls the spread of
malignant melanoma — an often
deadly form of cancer.
The study — conducted on
laboratory mice — stopped the
cancer from spreading by inoculat-ing
the animals with genetic
material from human chromosome
6. The research should aid doctors
in distinguishing between mela-nomas
that will colonize other
organs from those that will not,
and may eventually contribute to
the improved treatment of the
increasing illness.
Penn State Drs. Jeong- Hyung
Lee and Danny Welch, and
UNC- CH graduate student Karen
Phillips and Dr. Bernard Weiss-man,
associate professor of pathol-ogy
and UNC Lineberger member,
authored the report. Dr. Jeffrey
Trent of the National Center for
Human Genome Research helped
with the study.
“ If this ( study) indicates there
are targets for therapy that would
prevent human tumors from
spreading from their original site,
that would be a tremendous boon
for therapy,” Weissman says.
Drs. Isaiah Fidler and Robert
Radinsky of the M. D. Anderson
Cancer Center wrote in an accom-panying
journal editorial, �� Regard-less
of formidable challenges, the
new understanding of molecular
biology of cancer metastasis .. .
offers unprecedented opportunities
for the inhibition of therapy of
cancer metastasis. We are looking
forward to these advancements.”
A report on the findings
appeared in the Journal of the
National Cancer Institute. n
NEWS BRIEF
UNC Lineberger Scientists Discover
Gene For Melanoma Metastasis
after onset. So genetic counselors act
as detectives, looking for clues from
past generations and other members of
a person’s own generation. This creates
a diagram of family history which helps
to establish the pattern of inheritance
specific to a disease.
The idea is to provide people with
information so they can form a plan of
action. For instance, if you know there
is a strong incidence of breast cancer
in your family, you might take a more
aggressive approach to early detection
and prevention. There is also the fear
of the unknown, Skrzynia says.
“ Sometimes people just want to know
they’re susceptible. Knowing makes it
less scary.” On the flip side, however,
there are many people who feel what
they don’t know can’t hurt them.
That’s why genetic testing isn’t for
everyone. “ Some of us don’t want to
know about our own genes,” Skrzynia
admits. Psychological issues complicate
matters. “ For some there is the benefit
of knowing rather than worrying about
knowing.” Concerns about confidenti-ality,
family impact, and insurance also
play a role in deciding about testing.
A LONG JOURNEY
Once the decision to know is made,
the journey is really just beginning,
and there are many stops along the
road. Here’s a typical course for a
breast cancer patient:
Visit one: Meet with an oncologist,
genetic counselor and clinical social
worker for a clinical breast exam, treat-ment
options, a review of genetic test-ing
options and a psychological assess-ment.
It can take from two to four
weeks for the patient to process this
information and decide whether to
pursue testing. For those wanting to
continue the journey and who fulfill
the criteria for testing, there is more:
Visit two: Meet with the genetic
counselor to review the informed
consent and discuss testing — which
involves two different labs and several
techniques— and have blood drawn.
“ This testing takes some time,”
Skrzynia says, “ because we check and
double check every result. My job is
only as good as the results I get.”
Visit three: Meet with the three-person
team again to get results and
discuss follow- up and management.
After the final visit, Skrzynia and
her team continue to follow up with
patients periodically, “ because things
change. We are in a long- term rela-tionship
with our patients. That gives
us a unique opportunity to learn from
them and to provide them with state-of-
the- art medicine.” n
CANCER L I N E S SPRING 1997 VOLUME 7, ISSUE I
PAGE 10
Acomponent of soybeans called
genistein so far looks extremely
promising in preventing cancer,
according to UNC medical scientists.
Researchers launched a new study of
the protein which stops human
tumor cells from growing in laboratory
culture and inhibits cancer in rats, to
investigate the possibilities.
“ We know the Japanese, who eat
diets rich in soybeans, take in about
80 milligrams of genistein a day, and
that’s as much as 80 times more than
we Americans do,” says Dr. Steven
Zeisel, chairman of nutrition at the
UNC- Chapel Hill schools of public
health and medicine. “ Japanese people
eat much of their genistein in the form
of soybean curd they call tofu, and
they have very low rates of breast and
prostate cancer compared to us.”
Because no scientific data exist yet
on what genistein does in humans, the
National Cancer Institute asked the
UNC researchers to look into it and is
providing purified genistein as well
as assisting in the study design. The
institute is supporting their work with
$ 785,000 for the first year and likely
will expand the studies later.
“ The institute has asked us to do
two things,” Zeisel said. “ First, we will
study healthy people and patients with
prostate cancer to determine how high
a dose people can take without having
side effects. Once we establish that, we
have an understand-ing
that NCI will
fund a larger study
in which patients
newly diagnosed
with prostate cancer
are randomly
assigned either to
receive nothing or
receive medium
to high doses of the
protein.”
Several weeks
later, when patients
go into surgery, re-searchers
will com-pare
their tumors
to see if treatment
with genistein
has affected tumor
growth.
“ We expect that
the protein should
NEWS BRIEF
Soybeans Could Hold KeyTo Cancer Control
by David Williamson
1996 Lineberger Fellow Award recipients are graduate students ( l- r),
Keh- Chuang Chin, Suzanne M. Graham and William L. Miller. Fellows
receive a $ 3,000 supplementary stipend to recognize the excellence of their
research activities. They were selected by the Center’s Program Planning
Committee and honored at the fall meeting of the Center’s Board of
Visitors, which started the awards in 1987 to encourage promising new
cancer researchers. Program funding comes from Best Distributing Co. in
Goldsboro and The Brown F. Finch Foundation in Winston- Salem.
LINEBERGER SNAP SHOT
be able to convert cancer cells in a way
that makes them less able to divide
and grow,” said Zeisel, a member of the
UNC Lineberger Comprehensive Can-cer
Center. “ We believe that treatment
will inhibit the signal that cells use to
tell themselves to grow and multiply.”
If the research turns out as hoped,
it will provide the first evidence that
genistein can stop or retard cancer in
humans, he said. The institute then
will fund a large study of its effective-ness
at multiple medical centers across
the country.
“ There is no reason to think
genistein will not be safe because the
Japanese already are consuming so
much,” the scientist said. “ We will
determine how it is delivered into the
blood, the rate at which delivery
occurs and whether patients should be
dosed twice or three times a day.”
Genistein is known as a phyto-estrogen.
It is believed to slow cancer
to the point where the immune
systems of animals — and hopefully
humans — can catch up with cancers
and eliminate them.
Lineberger Center members Gary
J. Smith, professor of pathology and
laboratory medicine; James L. Mohler,
associate professor of surgery; and
Paul Godley, assistant professor of
medicine are participating as well as
research dietitian Marjorie Busby, and
Dr. William D. Heizer, professor
of medicine. The scientists will collab-orate
with others at the Research
Triangle Institute who will conduct
biochemistry studies. n
The UNC Lineberger Comprehensive Cancer Center sponsors several on- going cancer support groups. For more information about the schedule,
contact Anne Washburn, Patient/ Family Resource Center Coordinator, 919- 966- 3097.
FOR MORE INFO
WHAT WHEN WHERE CONTACT
CANCER SUPPORT GROUP Every Tuesday Patient/ Family Resource Center Anne Washburn,
from noon- 1: 00pm Ground Floor Coordinator
NC Clinical Center Patient/ Family Resource
UNC Hospitals Center
Chapel Hill, NC 919- 966- 3097
Fearrington Group The Gathering Place Anne Washburn
meets the second Thursday Fearrington Village 919- 966- 3097
of each month Pittsboro, NC
AFRICAN- AMERICAN BREAST The third Thursday American Cancer Society Office Pearl Shelby,
CANCER SUPPORT GROUP of each month Westgate Plaza Facilitator
from 7: 00- 8: 00 pm 3500 Westgate Drive 919- 682- 3316
Durham, NC
CENTRAL PIEDMONT AREA The second Wednesday Clover’s Mastectomy and Dondi Alston,
AFRICAN- AMERICAN BREAST of each month Medical Supply Shop Facilitator
CANCER SUPPORT GROUP from 6: 30- 7: 30pm 1242 S. Church Street 910- 222- 1129 or
Burlington, NC 910- 222- 8052
PROSTATE CANCER SUPPORT GROUP The first Wednesday Chapel Hill Senior Center Bernadette Williams,
of each month 400 S. Elliot Road Nurse Clinician
from 4: 00- 5: 00pm Chapel Hill, NC 919- 966- 2571
Fearrington Group The Gathering Place * To confirm meeting
meets the last Friday Fearrington Village date, please call
of each month* Pittsboro, NC Bernadette Williams
CANCER SURVIVORS SUPPORT GROUP The second Tuesday Chapel Hill Senior Center Anne Washburn,
of each month 400 S. Elliot Road Patient Ed. coordinator
from 7: 00- 8: 30pm Chapel Hill, NC 919- 966- 3097
BONE MARROWTRANSPLANT GROUP Every Thursday Fifth Floor Mary Jackson,
from 1: 00- 2: 00pm Anderson Pavilion Classroom Clinical Social Worker
UNC Hospitals 919- 966- 7850
SANFORD CANCER SUPPORT GROUP The first Thursday Enrichment Center Linda Rudeseal
of each month Sanford, NC 919- 775- 2692
7: 00- 8: 30pm
SPOUSES AND PARTNERS OF CANCER The second Monday Chapel Hill Senior Center Anne Washburn,
PATIENTS SUPPORT GROUP of each month 400 S. Elliot Road Patient Ed. coordinator
from 7: 30- 9: 00pm Chapel Hill, NC 919- 966- 3097
GYNECOLOGIC CANCER SUPPORT The fourth Wednesday Chartwell Anne Washburn,
GROUP * of each month 133 Southcentral Ct, Suite 400 Patient Ed. coordinator
from 7: 00- 8: 30pm Morrisville, NC 919- 966- 3097
* Co- sponsored with Duke Comprehensive Cancer Center and Rex Cancer Center
VOLUME 7, ISSUE I SPRING 1997 CANCER L I N E S
PAGE 11
UNC Lineberger Comprehensive Cancer Center/
UNC Hospitals Support Groups
CANCER L I N E S SPRING 1997 VOLUME 7, ISSUE I
PAGE 12
UNC Lineberger Comprehensive Cancer Center
CB# 7295
School of Medicine
University of North Carolina at Chapel Hill
Chapel Hill, NC 27599- 7295
( 919) 966- 3036
______________
Return Forwarding, and Return Postage Guaranteed.
Address Correction Requested.
Nonprofit Organization
U. S. Postage
PAID
Permit No. 71
Chapel Hill, NC 27599- 1110
Printed on Recycled Paper
LINEBERGER SNAP SHOT
Visit the UNC Lineberger Center on the Internet. Our homepage
address is http:// www. med. unc. edu/ wrkunits/ 3ctrpgm/ lccc/
UNC Lineberger Center on the Internet
( l- r) Dr. Bill Friday, Wilmington business executive Henry Longley and UNC professor
and UNC Lineberger Board of Visitors member Chuck Stone are co- chairing a $ 3 million
campaign to support the Prostate Cancer Research Program at UNC. The program is focusing
on: the molecular biology and genetics of prostate cancer to discover why and how the cancer
develops; translation of basic science discoveries into new treatments and procedures; and
research into the early detection and prevention of prostate cancer to find cancer early or to
avoid it altogether.
July 4,1997
“ Freedom From from Cancer”
Fundraiser
Co- hosted with Duke
Comprehensive Cancer Center
Wallace Wade Stadium
Durham, NC
August 2,1997
“ Chasing the Horizon”
Pediatric Oncology Fundraiser
Wilmington, N. C.
November 7,1997
UNC Lineberger Building
Dedication and Fall Board of
Visitors Meeting
Chapel Hill, N. C.
Lineberger
Events
U P C O M I N G

U N C L I N E B E R G E R C O M P R E H E N S I V E C A N C E R C E N T E R • S P R I N G 1 9 9 7 CANCER L I N E S
U N C S C H O O L O F M E D I C I N E • U N C H O S P I T A L S
Pagano Receives State’s Highest Honor
Joseph S. Pagano, director
of the UNC Lineberger Compre-hensive
Cancer Center and
Lineberger Professor of Cancer
Research, was honored last
December with the 1996 North
Carolina Award for Science. It is
the highest civilian honor the
state can bestow. North Carolina
is one of only a handful of states
to have a citizen awards program.
“ Dr. Pagano has earned
international recognition for
his ground- breaking research
and I’m proud he has received
the North Carolina Award,”
said Governor James B. Hunt,
Jr. “ His dedication has helped
cancer patients and AIDS
patients live longer, and our state is
very lucky to have him.”
Pagano’s research has focused on
the Epstein- Barr virus ( EBV), a human
herpesvirus that causes mononucleosis
and has been linked to several types of
cancer. He was recognized for his land-mark
development of new ways to de-tect
viruses in cells by looking for viral
DNA. Through his research, Pagano
discovered that the DNA of EBV was
present in both an African cancer
called Burkitt’s lymphoma and in naso-pharyngeal
carcinoma, a cancer com-mon
in southern China. This discov-ery
showed that EBV could cause can-cer
in two very different types of cells.
I N S I D E T H I S I S S U E . . .
Message from the Director . . . . . . . . . . 2
Clinical Trials Underway . . . . . . . . . . . . . 3
In Profile: Bill Cance . . . . . . . . . . . . . . . 5
UNCDiscovers Tumor Defense . . . . . . 6
Cancer Study & Diet Research. . . . . . . 7
Genetic Counseling . . . . . . . . . . . . . . . . 8
Soybeans KeyTo Cancer Control . . . 10
Support Groups . . . . . . . . . . . . . . . . . 11
He then found that EBV remained
in the host cell as a minichromosome
in these cancers. This viral fragment,
an episome, partners with the host
cell’s DNA and is replicated when the
cell divides, allowing EBV to persist
indefinitely in the body after infection.
Other herpesviruses may use similar
strategems.
“ Discovering how viruses
replicate and persist is part of
Dr. Pagano’s long- term goal
of learning how to control viral
infection,” Gov. Hunt said in
his citation.
Pagano also received acco-lades
from his colleagues. “ Dr.
Pagano is one of the few in-dividuals
in this country whose
contributions range from basic
virology at the molecular and
cellular levels through in vitro
studies of antiviral activity
to the conduct of clinical trials
with effective antiviral drugs,”
notes Dr. Gertrude B. Elion,
a Nobel Laureate scientist at
Glaxo Wellcome cancer center
member emeritus. Pagano’s
research with HIV and antiviral drugs
laid the groundwork for the creation of
the AIDS Center at UNC. It also
prompted the FDA to seek his advice
on the first HIV vaccine based on gene
transfer. Elion credits him with develop-ing
one of the strongest cancer center
programs in the nation with training,
research and outreach components.
Continued on page 3
Dr. Joseph Pagano, Center director, receives the North Carolina Award
from Governor James B. Hunt
by Margot Carmichael Lester
SPRING 1997 VOLUME 7, ISSUE I
PAGE 2
Director’s Message
CANCER L I N E S
Coming to completion is our
new building. This summer, four
structures will merge, linking physi-cally
for the first time the center’s
research programs in basic, clinical
and public health sciences. The
glass- enclosed, domed atrium will be
the space through which everyone
passes, a place of encounter that
captures the interdisciplinary culture
of the center. It will be a place of
discovery and light. We anticipate a
fall dedication ceremony.
Also coming to completion is my
time as director. I am excited about
what will come next: a new director
who will infuse new ideas and leader-ship
while keeping the best of the
past. There is more to be accom-plished
as Director Emeritus, and I
will continue as Lineberger Professor
of Cancer Research, with more time
for my laboratory program — now
come full circle from basic studies of
viral genes to the treatment of human
cancer grown in mice. I will continue
to direct the center’s postdoctoral
training program, now ranked nation-ally
with those at the top. Attracting
the best and the brightest young
people to cancer research is one of the
more rewarding of our priorities.
Twenty- three years ago when
most cancer centers were working on
proving therapies that were already
available, I knew that we would need
to go back to a more fundamental
approach. It would be rooted in
understanding how cancer arises in
the cell, a conviction coming from
working with viruses in cells. Folded
Dr. Joseph S. Pagano
in this first plan would be cancer
control research through UNC’s
excellent School of Public Health.
Rapid payoffs would come from pre-vention
and early detection of cancer.
We were already treating cancer
patients, ever mindful of the pressing
need for the best therapy. Clinical
research would be developed as the
Center had something new to offer.
We have been steadfast in following
that plan. The emergence of cancer
genetics, unexpected as it was, fit well
with this strategy, but picked up the
tempo.
I know full well that patients
with cancer want action: not just new
facilities, new faculty, and new pro-grams
in clinical research, but a
beneficial fusion between discovery in
the laboratory and the best in treat-ment
and care, and a leap from
insight into cancer genes to forecast-ing
cancer susceptibility to guide
prevention.
The vision of the center has been
tested, and it is now affirmed by the
waves of discovery of how cancer
arises in the cell and the genes that
predict behavior of cancer and suscep-tibility
to those most insidious of
diseases. The cancer center has the
momentum to be in the vanguard to
the finish. n
Cancer Lines is a
semi- annual publication
of the UNC Lineberger
Comprehensive Cancer
Center, The University of
North Carolina School of
Medicine at Chapel Hill.
Dr. Joseph S. Pagano, Director
Dianne G. Shaw, Director of
Communications/ Executive Editor
Margot Carmichael Lester, Editor
n Please remove me from your mailing list
Name
n Please add the following to the Cancer
Center’s mailing list
Name
Address
City, State, Zip
UNC Lineberger
Comprehensive Cancer Center
CB# 7295
School of Medicine
University of North Carolina at Chapel Hill
Chapel Hill, NC 27599- 7295
( 919) 966- 3036
UNC Lineberger is designated a
comprehensive cancer center by the
National Cancer Institute.
VOLUME 7, ISSUE I SPRING 1997 CANCER L I N E S
PAGE 3
These are just a few highlights from
Pagano’s long career. “ The superlative
work of the UNC Lineberger
Comprehensive Cancer Center is the
ultimate measure and tribute to
Dr. Pagano’s leadership,” notes Stuart
Bondurant, M. D., interim dean of the
UNC School of Medicine.
“ While Dr. Pagano would be the
first to point out that many distin-guished
and able people have contrib-
PAGANO RECEIVES AWARD
Continued from page 1
NEWS BRIEFS
UNC Clinical Trials Underway
with a new drug, paclitaxel, which has
been shown to be very effective in
shrinking tumors of the esophagus,
head and neck area, breast, lung and
ovaries. Paclitaxel also appears to
be especially effective when used along
with irradiation in patients with
cancers of the lung or throat. The trial
is to show that this combination
of three drugs and irradiation is more
effective than the first two were with
irradiation and that it can be delivered
safely to patients with these tumors.
Recurrent Leukemia and
Lymphoma ( GW 1002) — This trial
will study the effectiveness and side
effects of a new drug called ARA- G,
which is being developed by Glaxo
Wellcome for treatment of patients
with recurrent leukemia and lym-phoma.
Initial work with this drug has
shown that it is very effective in treat-ing
certain patients with these
diseases. This study will examine the
drug’s ability to shrink these tumors
For more information on these and
other trials, please call the Clinical
Protocol Office at 919- 966- 4432.
Pancreatic Cancer ( LCCC 9620)
— This trial uses the first drug,
Gemcitabine, which has ever been
approved by the FDA for the treat-ment
of pancreatic cancer. Patients
with pancreatic cancers that cannot
be removed surgically will receive
Gemcitabine along with irradiation
to the tumor mass. It is believed
that along with Gemcitabine’s anti-tumor
activity, there is also reason
to expect that it will increase the
effectiveness of the irradiation and
make the tumor that much more
likely to shrink.
Esophageal Cancer ( LCCC 9622)
— This trial is for patients with
large, inoperable cancers of the
esophagus. Patients will receive a
combination of three chemotherapy
drugs, two of which have been used
at UNC to treat this cancer, along
when the medicine is given by a dif-ferent
schedule than it was in earlier
trials. The treatment includes receiv-ing
three days of the medicine in the
hospital. Treatments are repeated
every four weeks if there is evidence
of the cancer’s improving with
therapy.
Ovarian Cancer ( GOG- 164) —
This randomized trial will compare
two different treatments in patients
who had a good, but not complete,
response to standard doses of
chemotherapy as initial treatment for
their ovarian cancer. One group of
patients will receive six additional
cycles of standard doses of carbo-platin
and paclitaxel. The other
group will receive a single treatment
with high doses of chemotherapy and
blood stem cells ( stem cell trans-plant)
for any residual ovarian cancer
found at the time of the second- look
surgery. n
uted to building the Center,” Bon-durant
continues, “ it is also true that
the Center’s greatness rests upon his
vision, commitment, personal and sci-entific
standards, scientific competence
and personal sensitivity and warmth.”
“ Dr. Pagano’s career exemplifies
that work as a scientist can make a
difference to society,” says Mary K.
Estes, Ph. D., a former student who is
now professor of molecular virology at
the Baylor College of Medicine and
president of the American Society for
Virology. “ He always showed this by
exhibiting a can- do attitude. This
doesn’t mean that everything always
comes easily, but he has shown that
one must be persistent to fulfill one’s
dreams. This attitude translated into
real accomplishments for the people
of North Carolina.”
Concludes Bondurant: “ The ulti-mate
result of Dr. Pagano’s leadership
is tangible improvement in the preven-tion,
diagnosis and treatment of cancer
in North Carolina, throughout the
nation and the world.” n
SPRING 1997 VOLUME 7, ISSUE I
PAGE 4
CANCER L I N E S
counselors, works to increase aware-ness
about breast cancer and partners
with community health organizations
to offer breast cancer control activities.
Using the U. S. Championship grant,
SOS will create educational materials
and a videotape for the program.
SOS was begun in 1990 as a part
of the UNC Minority Cancer Control
Research of the UNC Lineberger
Comprehensive Cancer Center. n
— compiled by Melyssa Allen
breast cancer prevention and detec-tion,
awarded the Center a total of
$ 45,000. The funds will be used for
the Center’s SPORE and Save Our
Sisters ( SOS) programs.
The UNC Breast Cancer SPORE
( specialized Program of Research
Excellence) is one of six such programs
in the country funded by the National
Cancer Institute ( NCI). SPOREs
are national leaders in breast cancer
research with a focus on translating
new discoveries in scientific and
clinical practices. UNC Lineberger
will use the $ 25,000 grant to further a
frontiers program that will allow for
new, one- year research projects target-ing
breast cancer treatment, early
detection and education.
The SOS program received a
$ 20,000 grant. SOS works to improve
breast cancer education for older
African- American women living
in the Wilmington area. The program,
which offers social support and
counseling through 128 lay health
DEVELOPMENT NEWS
Organizations Fund Breast Cancer Research
Two organizations have lent
considerable financial support to the
UNC Lineberger Comprehensive
Cancer Center for its clinical programs
in breast cancer research.
BREAST CANCER RESEARCH
FOUNDATION GIFT
The Breast Cancer Research Foun-dation,
founded in 1993 by Evelyn
Lauder of the Estee Lauder Com-panies,
gave $ 85,000 to the Center for
its clinical programs in breast cancer
research. Awards were given to 10
grantees across the nation at the
Foundation’s luncheon at NewYork
City’s Metropolitan Club on October
28, 1996. Barbara Walters of ABC
News presented the award.
“ The Breast Cancer Research
Foundation takes great pride in our
association with the UNC Lineberger
Comprehensive Cancer Center,”
Lauder said. “ Let us hope that by
working together, we move closer to
answering the many questions about
breast cancer and to finally eradicating
this dread disease.”
U. S. WOMEN’S OPEN
CHAMPIONSHIP GIFT
Two new grants from the 1996
U. S. Women’s Open Championship
will allow the UNC Lineberger
Comprehensive Cancer Center to pro-vide
new ways to treat breast cancer,
increase early detection and improve
breast cancer education.
The Championship, held in 1996
in Southern Pines to raise money for
Evelyn Lauder,
founder of the
Breast Cancer
Research Foun-dation,
presents
a 1996- 1997
Clinical Breast
Cancer Research
award to Dr.
Edison Liu, asso-ciate
professor
of medicine, and
Denise Bittner,
director of devel-opment
of the
UNC Lineberger
Comprehensive
Cancer Center.
Susan G. Komen Foundation
June 7, 1997
Meredith College
Raleigh, NC
For more information, call
919- 493- CURE
Race For The Cure
OR or lab, Cance engages in another
kind of gene- based activity: he’s an
avid gardener who propagates hybrid
gladioluses, just like his father.
FROM THE OPERATING
ROOM TO THE LAB
Cance and his team have un-covered
a new gene, called FAK,
which is involved in cellular signaling.
It was first found in a human tumor
taken from a sarcoma in a UNC
patient. “ The FAK gene is important
because it turns on as tumor cells
invade or metastasize. When it turns
off, the tumor cells die off,” Cance
explains. Researchers are studying the
gene now to discover how to use
it in treating cancer and preventing
metastases.
Research is the key to finding
new therapies and preventive measures
for cancer, Cance notes. At UNC,
information is taken directly from the
operating room to the lab, providing
almost instant access to cancer cells
for detailed study. Cance is involved
in the entire process, operating on
patients and then studying the cancer
cells. “ The sample is examined for
genes abnormally expressed — then
we try to figure out what makes it a
bad actor or a good actor.”
“ The key is taking the information
we find in the lab back to the patient,”
he continues. “ That’s what we pride
ourselves on here.” n
IN PROFILE
Surgeon/ Researcher Links OR and Lab
Bill Cance is one of those people
who actually grew up to be exactly
what he told his fourth grade class he
wanted to be: a surgeon. Today, if you
ask the associate professor of surgery
what he likes most about his job, he’ll
respond without hesitation. “ I love
taking care of people with complex
cancers.” A surgical oncologist, he
likes nothing better than a challenging
case so he specializes in cancers of the
upper abdomen and pelvis and breast.
“ One- hundred years ago we had
nothing in terms of surgical oncology,”
Cance notes.“ Then we had extraordi-narily
radical surgical solutions, like
mastectomy or colostomy. Today we’ve
found we can achieve the same results
with much less radical surgery.”
That change is especially notice-able
in the surgical options for breast
and colorectal cancers, he says. For
instance, mastectomies can often
be replaced with lumpectomies and
radiation; colostomies can often be
replaced with local excision or other
procedures.“ That translates into less
fear on the patient’s part which might
lead people to seek treatment sooner
instead of avoiding a worst- case
scenario. Conquering patients’ fear of
treatment is critical.”
LOOKING BEYOND
Not content to look at cancer
solely from a surgical standpoint,
Cance shuttles between the operating
room and the lab, trading his surgical
greens for his lab coat and back again.
Cance’s research aims to do the same
thing.
“ I like to ask the next question,”
Cance says. “ I look beyond the surgical
solution to what can we do to impact
the disease.” That makes him a perfect
fit at UNC, where a truly collaborative
approach to cancer treatment and
prevention is practiced. “ At UNC, the
three cancer specialties work together
to form a multidisciplinary team.”
That means medical, surgical and radi-ological
oncologists work together in
treating each patient. That’s rare —
in many other institutions, specialists
work independently. “ Our collabora-tive
environment means better care for
our patients — and a stronger research
agenda.
“ Down the road, novel thera-peutics
for cancers are the key,” Cance
predicts. Gene- directed therapies are
particularly promising and have gotten
his attention. That’s not surprising —
when he’s not treating cancer in the
PAGE 5
VOLUME 7, ISSUE I SPRING 1997 CANCER L I N E S
protein activates expression of or “ turns
on,” genes involved in cell survival.
Two related papers by scientists
at the Salk Institute in La Jolla, Calif.,
and the Massachusetts Institute of
Technology also appear in Science.
The papers report findings — limited
to tumor necrosis factor — similar to
those of the UNC- CH investigators.
As a group, the three reports appear to
explain why clinical trials using tumor
necrosis factor to fight cancer have
been disappointing.
“ This is a good example of how
basic research on gene expression and
cell biology can have important impli-cations
for cancer and clinical treat-ment,”
Baldwin said. “ We didn’t start
out studying this as a potential cancer
therapy but rather to understand
its biology. Working at the Lineberger
Cancer Center helped us appreciate
how our work could translate into
a real payoff in cancer treatment.” n
grammed cell death that enables the
body to clear the way for new cells.
Wang, Mayo and Baldwin found that
a substance known as NF- kappa B
prevents apoptosis from occurring in
cancer cells even after they have been
subjected to radiation, chemotherapy
or another killing compound called
tumor necrosis factor. NF- kappa B is a
major transcription factor — a protein
that attaches to DNA inside the
nucleus of cells and turns genes on and
off like a switch.
“ This factor protects the cells from
the killing mechanisms induced by
cancer therapies,” Baldwin said. “ We
also found that by blocking activation
of NF- kappa B, we make these cancer
therapies much more effective in
killing tumor cells in tissue culture.”
It is not known yet how NF- kappa B
prevents cell death or why blocking it
causes tumor cells to die, Baldwin said.
He and his colleagues assume that the
Anaturally occurring mechanism
that allows tumors to protect them-selves
against radiation treatment and
chemotherapy has been discovered
by scientists at the University of
North Carolina at Chapel Hill School
of Medicine. The researchers also have
figured out how to turn that mecha-nism
off.
If their discovery works as well in
patients as it has on a variety of
cultured human cancer cells, it could
improve cancer treatment and boost
survival significantly, the scientists say.
A report on the findings appeared
in the journal Science. Authors are
Cun- Yu Wang, a UNC- CH curriculum
in genetics and molecular biology
graduate student, Dr. Marty W. Mayo,
postdoctoral fellow, and Dr. Albert
S. Baldwin Jr., associate professor
of biology, all at the UNC Lineberger
Comprehensive Cancer Center.
The National Institutes of Health sup-ported
the research.
“ We are very excited about this
work and our clinical people here are
excited, too,” Baldwin said. “ We are
optimistic that it will improve cancer
therapy, and it offers real hope for stub-born
tumors like lung cancer. “ Depend-ing
on the success of animal studies
now under way, preliminary human tri-als
could start within a year,” he said.
The research concentrated on
apoptosis — a natural process of pro-
SPRING 1997 VOLUME 7, ISSUE I
NEWS BRIEFS
UNC Scientists
Discover Tumor
Defense, How
To Switch It Off
PAGE 6
CANCER L I N E S
Lucy and John Bode of Raleigh, NC, received the 1996 Outstanding Service Award at the Lineberger
Center’s Board of Visitors meeting. The Bodes are founding members of the Board of Visitors, serving on
the Board since its creation in 1984, and on its executive committee. ( l- r) Center director Dr. Joseph
Pagano; Lucy Bode; John Bode; Center deputy director Dr. Shelley Earp.
LINEBERGER SNAP SHOT
NEWS BRIEFS
PAGE 7
VOLUME 7, ISSUE I SPRING 1997 CANCER L I N E S
New Colon
Cancer Study
Among Blacks
and Whites
Afour- year, $ 2.6 million grant
from the National Cancer Institute is
allowing researchers at the University
of North Carolina at Chapel Hill
Schools of Medicine and Public
Health to launch what they believe is
the largest study of colon cancer in
both black and white races.
Colon cancer has been the second-leading
cancer killer in America for
the past 25 years. Deaths have been
decreasing among whites but increas-ing
among blacks and no large studies
have ever been done to find out why.
“ We have a lot of questions we
hope to answer,” said Dr. Robert
Sandler, professor of medicine, UNC
Lineberger member and principal
investigator. “ When people move from
a low- incidence area such as Africa or
Japan to a high- incidence area such as
the United States, the disease rates go
up. That strongly suggests that some-thing
in the environment rather than
simply genetics is responsible.”
Thirty- three counties in central
and eastern North Carolina, 50 hos-pitals,
800 colon cancer patients and
800 healthy control subjects will be
involved.
“ For us to come up with valid,
useful answers we need as many eligi-ble
people as possible to participate.”
He plans on contacting patients
through the North Carolina Central
Cancer Registry by mail and then by
phone to seek their cooperation,
after getting permission from their
physicians.
“ One of the strengths of our study
will be that we will be able to look at
a comprehensive list of factors such as
diet and physical activity in such a
large group,” Sandler explains. This is
a great opportunity for people in the
community and the University to help
one another by learning why blacks
in this country are at a greater risk of
dying from colon cancer than whites.”
Cancer Center members Drs.
Robert Millikan and Beth Newman of
epidemiology, and Alice Ammerman
of nutrition, are involved in the study.
Also taking part are Drs. John Woosley
of pathology, Lawrence Kupper of
biostatistics and Richard Rippe of
medicine.
Diet Research
For Blacks
Could Help
Prevent Cancer
Astudy by the School of Public
Health at the University of North
Carolina at Chapel Hill is focusing on
reducing the risk of cancer among
black North Carolinians by helping
them change their eating habits.
The program, headed by nutrition
professor Dr. Boyd Switzer, is a church-based
effort in eight North Carolina
counties: Bladen, Craven, Cumber-land,
Durham, Harnett, New Hanover,
Onslow and Pender.
The $ 4 million study, funded by
the National Cancer Institute, is the
first of its kind to focus specifically on
black Americans and help them learn
about cancer preventive foods, said
Switzer, a member of the UNC Line-berger
Comprehensive Cancer Center.
“ The study’s goal is to encourage
people to change their diets,” Switzer
explains. “ That is very difficult. We are
looking at the barriers and motivators
that behavioral change, and we are
looking at ways to measure that dietary
change.” Switzer said encouraging
people to eat more fruits and vegeta-bles
is important because research
studies consistently link the two food
groups with preventing cancer.
Blacks are at greater risk of develop-ing
cancer and dying from the disease
than whites, Switzer said. In 1997,
the American Cancer Society esti-mates
that 560 of every 100,000 blacks
will develop cancer compared to 469
of every 100,000 whites.
The program will offer educational
services aimed at lifelong eating
changes that will include food events,
health fairs and pastoral assistance
through bulletins, sermons and coun-seling.
Also included will be small
group activities like kitchen workshops
and church member input. Congre-gations
will receive bulletins, a
self- help “ Food for Health” packet,
inspirational booklets and audio tapes.
Participants will go through a
dietary risk test and complete a food
frequency survey after each phase
of the study, expected to be between
18 months and two years. n
— compiled by Claire Datillo
because a series of genes must fail be-fore
susceptibility is apparent. “ The way
heredity works in cancer has only re-cently
been appreciated as technologies
were developed to isolate genes. Now
we can diagnose cancer and test for
cancer susceptibility genes, but we can’t
cure all cancers yet,” says Skrzynia.
VALUABLE INFORMATION
“ You don’t inherit cancer, you in-herit
susceptibility to develop cancer,”
Skrzynia says. For instance, genetic
counseling is useful in about 5- 10% of
breast cancer and colon cancer cases.
“ In general, when there are multiple
family members diagnosed with cancers
of any sort, counseling can help to sort
out sporadic cases.”
Information is key to finding cancer
early and managing it effectively
SEVERAL BRANCHES
Genetic counseling is a broad field,
but there are three main branches: pre-natal,
pediatric and adult- onset diseases.
Prenatal genetic counseling involves
looking at the genetic makeup of a fetus
and estimating outcomes. More people
are probably familiar with this kind of
genetic counseling, Skrzynia says.
“ Pediatric genetic counseling, broadly
speaking, is geared towards problems in
development,” she adds.
But adult onset disease presents a
new area of genetic counseling. The
key here is detecting the gene or genes
which do not work properly. In some
diseases, such as Huntington’s disease
or neurofibromatosis, scientists know
there is one gene which determines
whether an individual will develop the
disease. Cancer is more complicated
SPRING 1997
CLINICAL REPORT
Genetic Counseling and Cancer
VOLUME 7, ISSUE I
Jane ( not her real name) is a
35- year- old African American woman.
For the past two years, she and her
sister have been caring for their
mother, Betty. Betty was diagnosed 15
years ago with breast cancer. After
a mastectomy, Betty did very well, but
cancer recurred in the other breast.
Betty has two sisters diagnosed
with breast cancer — three out of six
sisters suffer from the disease. Her
mother, Jane’s grandmother, died from
complications of “ female cancer,”
possibly uterine or ovarian cancer.
Jane has realized that cancer, as
she put it, “ runs in the family.” She,
her sister and her many cousins worry
about getting cancer and about
their own daughters. Jane recently read
a magazine article about the “ cancer
gene” and genetic testing. Should she
be tested? What is it all about?
A group of medical professionals
at UNC Lineberger work with people
like Jane every day to help them and
their families understand heredity
and disease. They work with people
with breast cancer, colon cancer, and
other types of cancer.
“ Genetic counseling is a com-munication
process,” Cecile Skrzynia,
a genetic counselor says.“ We explain
to patients and families facts about
hereditary diseases and what the risks
are to family members. Then we
talk about options for management.
Basically, genetic counselors help
people make decisions and choose
options to fit their families.”
PAGE 8
CANCER L I N E S
Genetic counselor Cecile Skrzynia talks with a breast cancer patient about the patient’s family history.
VOLUME 7, ISSUE I SPRING 1997 CANCER L I N E S
PAGE 9
Scientists at Pennsylvania State
University and the University of
North Carolina at Chapel Hill
have discovered a gene dubbed
KISS- 1 that controls the spread of
malignant melanoma — an often
deadly form of cancer.
The study — conducted on
laboratory mice — stopped the
cancer from spreading by inoculat-ing
the animals with genetic
material from human chromosome
6. The research should aid doctors
in distinguishing between mela-nomas
that will colonize other
organs from those that will not,
and may eventually contribute to
the improved treatment of the
increasing illness.
Penn State Drs. Jeong- Hyung
Lee and Danny Welch, and
UNC- CH graduate student Karen
Phillips and Dr. Bernard Weiss-man,
associate professor of pathol-ogy
and UNC Lineberger member,
authored the report. Dr. Jeffrey
Trent of the National Center for
Human Genome Research helped
with the study.
“ If this ( study) indicates there
are targets for therapy that would
prevent human tumors from
spreading from their original site,
that would be a tremendous boon
for therapy,” Weissman says.
Drs. Isaiah Fidler and Robert
Radinsky of the M. D. Anderson
Cancer Center wrote in an accom-panying
journal editorial, �� Regard-less
of formidable challenges, the
new understanding of molecular
biology of cancer metastasis .. .
offers unprecedented opportunities
for the inhibition of therapy of
cancer metastasis. We are looking
forward to these advancements.”
A report on the findings
appeared in the Journal of the
National Cancer Institute. n
NEWS BRIEF
UNC Lineberger Scientists Discover
Gene For Melanoma Metastasis
after onset. So genetic counselors act
as detectives, looking for clues from
past generations and other members of
a person’s own generation. This creates
a diagram of family history which helps
to establish the pattern of inheritance
specific to a disease.
The idea is to provide people with
information so they can form a plan of
action. For instance, if you know there
is a strong incidence of breast cancer
in your family, you might take a more
aggressive approach to early detection
and prevention. There is also the fear
of the unknown, Skrzynia says.
“ Sometimes people just want to know
they’re susceptible. Knowing makes it
less scary.” On the flip side, however,
there are many people who feel what
they don’t know can’t hurt them.
That’s why genetic testing isn’t for
everyone. “ Some of us don’t want to
know about our own genes,” Skrzynia
admits. Psychological issues complicate
matters. “ For some there is the benefit
of knowing rather than worrying about
knowing.” Concerns about confidenti-ality,
family impact, and insurance also
play a role in deciding about testing.
A LONG JOURNEY
Once the decision to know is made,
the journey is really just beginning,
and there are many stops along the
road. Here’s a typical course for a
breast cancer patient:
Visit one: Meet with an oncologist,
genetic counselor and clinical social
worker for a clinical breast exam, treat-ment
options, a review of genetic test-ing
options and a psychological assess-ment.
It can take from two to four
weeks for the patient to process this
information and decide whether to
pursue testing. For those wanting to
continue the journey and who fulfill
the criteria for testing, there is more:
Visit two: Meet with the genetic
counselor to review the informed
consent and discuss testing — which
involves two different labs and several
techniques— and have blood drawn.
“ This testing takes some time,”
Skrzynia says, “ because we check and
double check every result. My job is
only as good as the results I get.”
Visit three: Meet with the three-person
team again to get results and
discuss follow- up and management.
After the final visit, Skrzynia and
her team continue to follow up with
patients periodically, “ because things
change. We are in a long- term rela-tionship
with our patients. That gives
us a unique opportunity to learn from
them and to provide them with state-of-
the- art medicine.” n
CANCER L I N E S SPRING 1997 VOLUME 7, ISSUE I
PAGE 10
Acomponent of soybeans called
genistein so far looks extremely
promising in preventing cancer,
according to UNC medical scientists.
Researchers launched a new study of
the protein which stops human
tumor cells from growing in laboratory
culture and inhibits cancer in rats, to
investigate the possibilities.
“ We know the Japanese, who eat
diets rich in soybeans, take in about
80 milligrams of genistein a day, and
that’s as much as 80 times more than
we Americans do,” says Dr. Steven
Zeisel, chairman of nutrition at the
UNC- Chapel Hill schools of public
health and medicine. “ Japanese people
eat much of their genistein in the form
of soybean curd they call tofu, and
they have very low rates of breast and
prostate cancer compared to us.”
Because no scientific data exist yet
on what genistein does in humans, the
National Cancer Institute asked the
UNC researchers to look into it and is
providing purified genistein as well
as assisting in the study design. The
institute is supporting their work with
$ 785,000 for the first year and likely
will expand the studies later.
“ The institute has asked us to do
two things,” Zeisel said. “ First, we will
study healthy people and patients with
prostate cancer to determine how high
a dose people can take without having
side effects. Once we establish that, we
have an understand-ing
that NCI will
fund a larger study
in which patients
newly diagnosed
with prostate cancer
are randomly
assigned either to
receive nothing or
receive medium
to high doses of the
protein.”
Several weeks
later, when patients
go into surgery, re-searchers
will com-pare
their tumors
to see if treatment
with genistein
has affected tumor
growth.
“ We expect that
the protein should
NEWS BRIEF
Soybeans Could Hold KeyTo Cancer Control
by David Williamson
1996 Lineberger Fellow Award recipients are graduate students ( l- r),
Keh- Chuang Chin, Suzanne M. Graham and William L. Miller. Fellows
receive a $ 3,000 supplementary stipend to recognize the excellence of their
research activities. They were selected by the Center’s Program Planning
Committee and honored at the fall meeting of the Center’s Board of
Visitors, which started the awards in 1987 to encourage promising new
cancer researchers. Program funding comes from Best Distributing Co. in
Goldsboro and The Brown F. Finch Foundation in Winston- Salem.
LINEBERGER SNAP SHOT
be able to convert cancer cells in a way
that makes them less able to divide
and grow,” said Zeisel, a member of the
UNC Lineberger Comprehensive Can-cer
Center. “ We believe that treatment
will inhibit the signal that cells use to
tell themselves to grow and multiply.”
If the research turns out as hoped,
it will provide the first evidence that
genistein can stop or retard cancer in
humans, he said. The institute then
will fund a large study of its effective-ness
at multiple medical centers across
the country.
“ There is no reason to think
genistein will not be safe because the
Japanese already are consuming so
much,” the scientist said. “ We will
determine how it is delivered into the
blood, the rate at which delivery
occurs and whether patients should be
dosed twice or three times a day.”
Genistein is known as a phyto-estrogen.
It is believed to slow cancer
to the point where the immune
systems of animals — and hopefully
humans — can catch up with cancers
and eliminate them.
Lineberger Center members Gary
J. Smith, professor of pathology and
laboratory medicine; James L. Mohler,
associate professor of surgery; and
Paul Godley, assistant professor of
medicine are participating as well as
research dietitian Marjorie Busby, and
Dr. William D. Heizer, professor
of medicine. The scientists will collab-orate
with others at the Research
Triangle Institute who will conduct
biochemistry studies. n
The UNC Lineberger Comprehensive Cancer Center sponsors several on- going cancer support groups. For more information about the schedule,
contact Anne Washburn, Patient/ Family Resource Center Coordinator, 919- 966- 3097.
FOR MORE INFO
WHAT WHEN WHERE CONTACT
CANCER SUPPORT GROUP Every Tuesday Patient/ Family Resource Center Anne Washburn,
from noon- 1: 00pm Ground Floor Coordinator
NC Clinical Center Patient/ Family Resource
UNC Hospitals Center
Chapel Hill, NC 919- 966- 3097
Fearrington Group The Gathering Place Anne Washburn
meets the second Thursday Fearrington Village 919- 966- 3097
of each month Pittsboro, NC
AFRICAN- AMERICAN BREAST The third Thursday American Cancer Society Office Pearl Shelby,
CANCER SUPPORT GROUP of each month Westgate Plaza Facilitator
from 7: 00- 8: 00 pm 3500 Westgate Drive 919- 682- 3316
Durham, NC
CENTRAL PIEDMONT AREA The second Wednesday Clover’s Mastectomy and Dondi Alston,
AFRICAN- AMERICAN BREAST of each month Medical Supply Shop Facilitator
CANCER SUPPORT GROUP from 6: 30- 7: 30pm 1242 S. Church Street 910- 222- 1129 or
Burlington, NC 910- 222- 8052
PROSTATE CANCER SUPPORT GROUP The first Wednesday Chapel Hill Senior Center Bernadette Williams,
of each month 400 S. Elliot Road Nurse Clinician
from 4: 00- 5: 00pm Chapel Hill, NC 919- 966- 2571
Fearrington Group The Gathering Place * To confirm meeting
meets the last Friday Fearrington Village date, please call
of each month* Pittsboro, NC Bernadette Williams
CANCER SURVIVORS SUPPORT GROUP The second Tuesday Chapel Hill Senior Center Anne Washburn,
of each month 400 S. Elliot Road Patient Ed. coordinator
from 7: 00- 8: 30pm Chapel Hill, NC 919- 966- 3097
BONE MARROWTRANSPLANT GROUP Every Thursday Fifth Floor Mary Jackson,
from 1: 00- 2: 00pm Anderson Pavilion Classroom Clinical Social Worker
UNC Hospitals 919- 966- 7850
SANFORD CANCER SUPPORT GROUP The first Thursday Enrichment Center Linda Rudeseal
of each month Sanford, NC 919- 775- 2692
7: 00- 8: 30pm
SPOUSES AND PARTNERS OF CANCER The second Monday Chapel Hill Senior Center Anne Washburn,
PATIENTS SUPPORT GROUP of each month 400 S. Elliot Road Patient Ed. coordinator
from 7: 30- 9: 00pm Chapel Hill, NC 919- 966- 3097
GYNECOLOGIC CANCER SUPPORT The fourth Wednesday Chartwell Anne Washburn,
GROUP * of each month 133 Southcentral Ct, Suite 400 Patient Ed. coordinator
from 7: 00- 8: 30pm Morrisville, NC 919- 966- 3097
* Co- sponsored with Duke Comprehensive Cancer Center and Rex Cancer Center
VOLUME 7, ISSUE I SPRING 1997 CANCER L I N E S
PAGE 11
UNC Lineberger Comprehensive Cancer Center/
UNC Hospitals Support Groups
CANCER L I N E S SPRING 1997 VOLUME 7, ISSUE I
PAGE 12
UNC Lineberger Comprehensive Cancer Center
CB# 7295
School of Medicine
University of North Carolina at Chapel Hill
Chapel Hill, NC 27599- 7295
( 919) 966- 3036
______________
Return Forwarding, and Return Postage Guaranteed.
Address Correction Requested.
Nonprofit Organization
U. S. Postage
PAID
Permit No. 71
Chapel Hill, NC 27599- 1110
Printed on Recycled Paper
LINEBERGER SNAP SHOT
Visit the UNC Lineberger Center on the Internet. Our homepage
address is http:// www. med. unc. edu/ wrkunits/ 3ctrpgm/ lccc/
UNC Lineberger Center on the Internet
( l- r) Dr. Bill Friday, Wilmington business executive Henry Longley and UNC professor
and UNC Lineberger Board of Visitors member Chuck Stone are co- chairing a $ 3 million
campaign to support the Prostate Cancer Research Program at UNC. The program is focusing
on: the molecular biology and genetics of prostate cancer to discover why and how the cancer
develops; translation of basic science discoveries into new treatments and procedures; and
research into the early detection and prevention of prostate cancer to find cancer early or to
avoid it altogether.
July 4,1997
“ Freedom From from Cancer”
Fundraiser
Co- hosted with Duke
Comprehensive Cancer Center
Wallace Wade Stadium
Durham, NC
August 2,1997
“ Chasing the Horizon”
Pediatric Oncology Fundraiser
Wilmington, N. C.
November 7,1997
UNC Lineberger Building
Dedication and Fall Board of
Visitors Meeting
Chapel Hill, N. C.
Lineberger
Events
U P C O M I N G